Vol 10, No 1 (2014)

Background. Prostate cancer (PC) is one of the most common malignant tumors in men. The total Gleason (Gleason index) scores are one of the most important prognostic factors in patients with PC. The expression of p53 and Ki-67 proteins is also considered as a prognostic factor.

Objective: to estimate the frequency with which the expression of these proteins shows up and to compare the findings with Gleason scores.

Materials and methods. This investigation studied prostatic drugs after radical prostatectomy. The Gleason scale was use to rate the grade of a tumor. The expression of Ki-67 and p53 was an immunohistochemical method. The data were statistically processed using Spearman’s cor-relation test.

Results. Based on the Gleason index, all the tumors were divided into 3 groups: 1) low grade (4–6 scores); 2) intermediate grade (7 scores); 3) high grade (8–10 scores). Group 1 included 5 (16 %) patients; Group 2 and 3 consisted of 19 (64 %) and 6 (20 %) patients, respectively. The expression of p53 and Ki-67 was observed in none of the low-grade tumor samples. There was a statistically significant relationship between higher Ki-67 proliferation and higher Gleason scores.

Conclusion. In accordance with the results of this investigation, the expression of the marker Ki-67 can be used as a prognostic factor in PC. At the same time, a possible relationship between p53 expression and prognosis in PC calls for further investigation.

Prostate cancer (PC) is the most common cancer among elderly males in the countries of North America and Europe. The mean age of patients with PC is 72–74 years old. A decision on a treatment option for elderly patients must be based on their somatic status and desire. Today radical operations for locally advanced PC are most commonly performed in older age groups (over 70 years). This is associated with the improvement of both medical equipment and surgical techniques. The patients’ good surgery tolerability is combined with satisfactory oncological results. However, because of age, the regenerative capacities of the patients in this group are diminished and postoperative restorative processes are slower and more difficult. Quality of life was assessed in the patients aged over 70 years who had undergone radical surgery in  our clinic for PC in the past 2 years.

Androgen deprivation therapy with luteinizing hormone-releasing hormone (LHRH) antagonists versus therapy with agonists of this hormone ensures a better disease control due to the rapider and persistent suppression of testosterone levels without a flare phenomenon and requires no preventive use of antiandrogens. The third-generation LHRH antagonist degarelix shows a good tolerability and causes no systemic al-lergic reactions inherent in the earlier known drugs of this group. As indicated, the use of degarelix was characterized by the longer response of prostate-specific antigen (PSA) with a lower risk of adverse reactions, namely, serious cardiovascular and osseous complications, urinary tract infections (UTI). Thus, in males with a history of cardiovascular diseases, the risk of serious cardiovascular events or death decreased by 56% just within the first year of degarelix therapy. The findings allow degarelix to be regarded as the drug of choice for first-line hormone therapy in patients with advanced PC, particularly in males with cardiovascular disease or a high risk for UTI and osseous complications.

Locally recurrent prostate cancer (PC) in the bladder neck can substantially worsen quality of life in patients and hinder further treatment when castration-resistant PC develops. The paper describes a clinical case of very high-risk PC in a 55-year-old patient in whom radical cystectomy (RCE) with removal of metastases in the bladder neck and the Bricker ileal conduit were performed for a local recurrence after radical retropubic prostatectomy (RPE). It gives the data of preoperative examination, the technical features of the primary operation RPE, the data of postoperative observation, the technical aspects and outcomes of еру surgery for a local recurrence, as well as the results of a 1.5-year follow-up after RCE.

Analyzed the surgical treatment of 154 patients with locally advanced pelvic tumors that required resection of the bladder or its complete removal. 67 (43.5 %) patients had colorectal cancer. In 53 (34.4 %) cases of cervical cancer in 21 (13.7 %) – ovarian cancer, 8 (5.2 %) – uterine cancer, in 5 (3.2 %) – a cancer of the vagina. In 41 (26.6 %) patients operation was accompanied by resection of the bladder, 113 (73.4 %) cases, the volume of surgery was pelvic exenteration.

Proposed surgical classification of locally advanced pelvic tumors and secondary destruction of the bladder with locally advanced tumors. Describes the criteria of choosing the optimal amount of intervention at different propagation of the tumor and the degree of involvement of the bladder. The perspective of large interventions to improve the results of treatment of patients with tumors of the pelvic localization.